Zoe Aslanpour

A systematic review of hospitalization resulting from medicine‐related problems in adult patients

Medicine‐related problems (MRPs) represent a major issue leading to hospitalization, especially in adult and elderly patients. The aims of this review are to investigate the prevalence, causes and major risk factors for MRPs leading to hospitalization in adult patients and to identify the main medicine classes involved.

A systematic review of qualitative research on the contributory factors leading to medicine-related problems from the perspectives of adult patients with cardiovascular diseases and diabetes mellitus

Objectives To synthesise contributing factors leading to medicine-related problems (MRPs) in adult patients with cardiovascular diseases and/or diabetes mellitus from their perspectives. Design A systematic literature review of qualitative studies regarding the contributory factors leading to MRPs, medication errors and non-adherence, followed by a thematic synthesis of the studies. Data sources We screened Pubmed, EMBASE, ISI Web of Knowledge, PsycInfo, International Pharmaceutical Abstract and PsycExtra for qualitative studies (interviews, focus groups and questionnaires of a qualitative nature). Review methods Thematic synthesis was achieved by coding and developing themes from the findings of qualitative studies. Results The synthesis yielded 21 studies that satisfied the inclusion and exclusion criteria. Three themes emerged that involved contributing factors to MRPs: patient-related factors including socioeconomic factors (beliefs, feeling victimised, history of the condition, lack of finance, lack of motivation and low self-esteem) and lifestyle factors (diet, lack of exercise/time to see the doctor, obesity, smoking and stress), medicine-related factors (belief in natural remedies, fear of medicine, lack of belief in medicines, lack of knowledge, non-adherence and polypharmacy) and condition-related factors (lack of knowledge/understanding, fear of condition and its complications, and lack of control). Conclusions MRPs represent a major health threat, especially among adult patients with cardiovascular diseases and/or diabetes mellitus. The patients’ perspectives uncovered hidden factors that could cause and/or contribute to MRPs in these groups of patients.

Medicine use and medicine‐related problems experienced by ethnic minority patients in the United Kingdom: a review

The aim of this review was to establish type(s) and possible cause(s) of medicine‐related problems (MRPs) experienced by ethnic minorities in the UK and to identify recommendations to support these patients in the effective use of medicines.

A systematic review of counterfeit and substandard medicines in field quality surveys

This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution - Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php

Hospitalisation Resulting from Medicine-Related Problems in Adult Patients with Cardiovascular Diseases and Diabetes in the United Kingdom and Saudi Arabia.

Cardiovascular diseases (CVDs) and diabetes (DM) are two interrelated conditions that have a heavy morbidity and mortality burden worldwide. Patients with the two conditions usually take multiple medicines and thus are more susceptible to medicine-related problems (MRPs). MRPs can occur at any stage of the treatment process and in many cases can lead to unplanned hospitalisations. The aim of the study was to determine the prevalence of hospitalisation resulting from MRPs in adult patients with CVDs and/or DM and to identify the main causes, risk factors, and medicine classes involved. A retrospective study included 300 adult patients from two hospitals, one in the United Kingdom and one in Saudi Arabia. To identify MRPs, medical records were reviewed for demographic data, clinical data, laboratory assay, and prescription records. A total of 197 (65.7%) patients had MRPs, of which less than 10% were severe. The main problems were lack of treatment effectiveness and adverse drug reactions. Moreover, polypharmacy and patient non-adherence were the main risk factors contributing to MRPs. The main medicine classes associated with MRPs were insulin and antihypertensive medicines. Further research should address the pharmaceutical care processes employed in treating CVDs and DM, and to empower patients/healthcare providers in tackling MRPs.

Hospital adoption of antimicrobial stewardship programmes in Gulf cooperation council countries: A review of existing evidence

Antimicrobial resistance is increasing at an alarming rate in the Gulf Cooperation Council (GCC) owing to the overuse and misuse of antimicrobials. Novel and rare multidrug-resistant strains can spread globally since the region is host to the largest expatriate population in the world as well as a pilgrimage destination for more than 4 million people annually. Adoption of antimicrobial stewardship programmes (ASPs) could improve the use of antimicrobials and reduce antimicrobial resistance in the region. However, despite the established benefits of these interventions, little is known about the level of their adoption in the region and the impact of these programmes on antimicrobial use and resistance. This study aimed to review existing evidence on the level of adoption of ASPs, the facilitators and barriers to their adoption, and outcomes of their adoption in GCC hospitals.

Factors contributing to medicine-related problems in adult patients with diabetes and/or cardiovascular diseases in Saudi Arabia: a qualitative study

Objectives To investigate the factors contributing to medicine-related problems (MRPs) among patients with cardiovascular diseases (CVDs) and/or diabetes in Saudi Arabia. Design Qualitative semistructured interviews were conducted. Interviews were audio recorded then transcribed into Microsoft Word. The transcribed interviews were then imported into the qualitative analysis software NVivo where thematic analysis was applied. Thematic synthesis was achieved by coding and developing subthemes/themes from the findings of the interviews. Setting Five healthcare centres in Najran, Saudi Arabia. Participants 25 adult patients with diabetes and/or CVDs. Results The study cohort included 16 men and 9 women with a median age of 61.8 years (40–85 years). Diabetes was the main condition encountered among 23 patients and CVDs were reported among 18 patients. Perceived factors leading to MRPs were of four types and related to: patient-, healthcare system-, clinical (condition-) and medicine-related factors. Patient-related factors were related to living situation, religious practices, diet/exercise and patients’ behaviour towards the condition and medicines. Healthcare system-related factors comprised sources and availability of medicines, ease of access to healthcare system and patient satisfaction with healthcare providers. Clinical (condition-) related factors associated with both the knowledge and control over condition, and effects of the condition among medicines intake. Medicine-related factors included lack of knowledge about medicines and medicine use. Conclusions The results of this study uncovered many factors associated with MRPs among patients with CVDs and diabetes in Saudi Arabia, especially in reference to lifestyle and medicine use. Improving communication with healthcare professional alongside the introduction of national clinical guidance would mitigate the unwanted health complications related to medicine use.

OHP-001 Health related quality of life and its associated factors among south asian and middle eastern patients with chronic diseases in the UK

Background The ethnic minority groups (EMGs) in general have a higher than average prevalence of chronic diseases.1 People from different cultural backgrounds may experience language barriers, demonstrate different needs and expectations which may affect their ability to use their medicines and access services effectively.1 This may lead to poor chronic disease management and health outcomes. Purpose To assess the quality of life (QoL) among South Asian (SA) and Middle Eastern (ME) patients and to investigate factors associated with lower EuroQol 5-dimension (EQ-5D) visual analogue scale (VAS). Material and methods A cross sectional survey study was conducted with a purposive sample of 80 participants. Patients were from SA and ME origins, aged over 18 years and prescribed three or more regular medicines. Patients were identified when presenting with a prescription. The EQ-5D-3L questionnaire was administered to participants in 7 pharmacies in London. Statistical analysis was used to investigate factors associated with lower EQ-5D VAS, such as patient characteristics, healthcare of participants, number and type of prescription and non-prescription medicines used by respondents. Data were entered and analysed using the Software Package for Statistical Analysis (SPSS) 21. Results Conclusion The results add to the volume of knowledge regarding the health status of SA and ME patient. Medical, policy and individual attention should be given to the management of chronic diseases and improvement of QoL in EMGs. References and/or Acknowledgements Alhomoud F, Dhillon S, Aslanpour Z, Smith F. Medicine use and medicine-related problems experienced by ethnic minority patients in the United Kingdom: A review. Int J Pharm Pract 2013;21:277-87 No conflict of interest.

OHP-024 Pharmacist focus group about quality of medicines and related issues

Background The quality of medicines is commonly established through pharmacopoeia testing. Medicines with quality issues can either be substandard or counterfeit according to the World Health Organisation. Limited research has addressed the perceptions of stakeholders about medicine quality and related issues and none were identified within the selected population. Furthermore, few studies report views about generic medicines as being counterfeit or of inferior quality, which could influence the acceptance and use of such medicines. Purpose To generate a range of views, attitudes and behaviour regarding medicine quality and related issues from the perspective of experienced pharmacists. Additionally, this study will inform the question design for future studies with different stakeholders in the selected population and find translation for technical terms such as counterfeit. Material and methods A focus group study was video-recorded and conducted in English with five experienced pharmacists following their informed consent. The questions were developed following a literature search and were arranged in a particular order where general questions were asked first and questions regarding counterfeits were asked at the end. Data were analysed thematically using a systematic strategy for focus group analysis. Results Eight themes emerged including the definition, perception, challenges, knowledge, experience, practices, price and recommendations for medicine quality. A good quality medicine was described in terms of its effect, similar to other studies. Participants believed that the quality of medicines in the selected country was high in contrast to some patients’ views. A single term was used to describe counterfeit medicines in their native language. Conclusion The result of this study indicates a possible gap between the pharmacists and some patients’ views about the quality of medicines in the selected country. Emerging themes were used to inform the question design in future studies with different stakeholders. The translation of the term counterfeit was achieved. References and/or acknowledgements The authors are thankful to the pharmacists in this study. No conflict of interest.